Saturday, July 2, 2011

Primal Docs and a Whole30

Hello there! Happy July. I've barely had a moment to do anything but tweet and follow the latest posts, but I did find this paper from January that I had meant to blog about - I believe Jamie sent it to me, and he did write about it… but it is interesting enough for a second look to be sure. I'll have a blog up on that one tomorrow.

Before that, though, I'd like to point your compasses to a couple of things. First off, Chris Armstrong of The Celiac Handbook approached me after reading my Wheat and Schizophrenia post over at Psychology Today. Turns out that Chris himself basically follows a primal/paleo lifestyle, and he developed the website Primal Docs in order to create a resource for people to find physicians (typically MDs or DOs) who would support and understand that lifestyle. You'll notice I'm one of the doctors over there, along with John Biffra and a growing group of very healthy-looking folks! I have to say it does disturb me that so many doctors seem to be struggling with metabolic syndrome these days. If doctors can't keep themselves healthy with all that supposed discipline and knowledge, how is it that everyone else can? And sure, doctors are only human, and perhaps it is good for a doctor to be a patient every now and again, but on the other hand, I wouldn't go to a mechanic whose car is always broken down.

Secondly, beginning yesterday I started a stricter little stint of paleo eating called the Whole30. The plan was designed by Dallas and Melissa Hartwig of Whole9Life, and in full disclosure they did send me a complimentary copy of their handbook, though they did not ask me to follow the program or mention them on my blog. The Whole30 is a bit different than my typical routine because there is to be no cheating, no added sugars, no sugarfree gum, no sugar substitutes (which I don't use except for the occasional Diet Coke. I know. I know. I'm addicted. I can stop drinking it for long periods, but I still crave it for some reason, and I would actually drink regular Coke instead, except that it is so sweet I can't stand it… so...) no alcohol, no white rice or white potatoes, and no dairy of any kind.

In my ordinary day-to-day eating I don't consider wine or dark chocolate a "cheat," white potatoes and white rice I consider perfectly fine though a bit less nutrient dense calorie per calorie than other foods, and I will regularly partake of some high-fat dairy (maybe some yogurt or heavy cream once a week, cheese once or twice a week, and pasture butter on a near daily basis). Also, every once in a while I will cook some things with raw honey or real maple syrup and I don't give it a second thought. Once a month I have some honey in my tea, even. Otherwise, I'll eat just about anything (such as a couple of slices of pizza, ice cream, bbq ribs from a restaurant, a miniature snickers bar from my daughters' halloween stash, mexican food complete with refried beans and a *few* corn chips, some restaurant french fries, even a cookie) maybe once every couple of weeks. What Mark Sisson would consider the "20%" I suppose, though it wouldn't equal nearly 20% of my diet if you don't count the white rice and potatoes or dark chocolate - I've had Mexican food probably twice this year so far, BBQ ribs twice, pizza (my most common cheat) once a month - you get the idea.

And in the past, maintaining my normal weight was a constant battle of exercising and accounting for macronutrients and scarfing down low-fat yogurt and cottage cheese… any night out at a restaurant or extra ice cream or whatever would have to be meticulously made up for, or my weight would creep up. Ever since switching to the paleo lifestyle (including IF), as long as I stick to it the majority of the time, I've been able to eat whatever I want (every now and again), decrease the amount of time spent exercising, and my weight doesn't budge. Which is nice. It takes all the worry out of eating, and some of the naughtiness out of cheating. I don't cheat because I'm craving (except the Diet Coke, which is the only cheat I'm ashamed of…), I cheat because Mexican Food can taste good, especially if you don't eat it all the time.

The first three months of paleo I was very strict with my plan, which was also dairy-free, alcohol free, and entirely gluten-free. While doing that plan, I stumbled upon the Primal Blueprint and what then was PaNu and Whole Health Source and did a lot more of my own investigating, which led me to my blog, of course, and eventually reading Perfect Health Diet. Thus developed my day to day eating, which is sort of a cross between PB and PHD, and right now I only supplement with a multimineral in the morning and magnesium at night.

I haven't been super-strict since July of last year, which is also when I stopped losing weight, I think. So in combination with CrossFit I wanted to see if I could get a bit leaner, and the support of the Whole30 twitter crowd seemed like a good way to do it. I feel good for the most part - maybe I will even feel better. Who knows. And while I don't think a tiny bit of casein in pasture butter or a tiny bit of honey in my tea or a glass of wine or white rice and white potatoes are major problems, the idea of the Whole30 is to banish any sugar cravings (which I don't think I have - unless that is part of the Diet Coke monster - though it is not just the aspartame, as I don't crave Diet Pepsi or those weird diet iced teas and Diet Dr. Pepper I gave up years and years ago because gives me a sugar crash, weirdly enough - it's just Diet Coke. Very strange. What do they put in that stuff?), and to have your diet consist entirely of very nutrient-dense foods. While moderate alcohol and white potatoes and white rice are fairly innocuous, they do reduce the nutrient density of the day.

Right now I'm in the middle of Day 2, and have a bunch of veggies and high quality protein at the ready, and will be substituting sweet potatoes and squash and probably a second daily serving of fruit for the white potatoes and rice, and coconut oil and olive oil for my usual butter. I'm not gonna lie - because I don't want to cook two separate meals all the time, and I like to get K2 into the kids, I'll be using pasture ghee from time to time, and I'm going to consider that Whole30 compliant too. This bit is a little deviation from Dallas and Melissa's advice - It's just 30 days, just do what we say and don't tweak. But I'm fairly certain that will be my only deviation. A lovely chilled glass of pinot grigio (and the fizz from the Diet Coke, I suppose) has been replaced with San Pellegrino Sparkling Natural Mineral Water and lime. It's inexpensive, has some minerals, and I always feel very sophisticated drinking it.

I do have a vacation planned in a few weeks - and that will be the hardest week of the Whole30, I'm sure. Well, we will see how it goes!

I only recently got off Diet Coke (funny that Tim Ferriss is likewise hooked on it!). I came across something in food reward reading that pointed out that the reason people develop a taste for beer (which is really god-awfully bitter at first) is that they eventually associate the taste (bad) with the calories that usually accompany it (good). You know, the wings, pizza and burgers.

I also recently watched a presentation by Nora Volkow on addiction, and she briefly discussed how curious it was that addicts keep wanting substances that stop delivering.

So perhaps it's not the cravings for the Diet Coke per se, but the brain's long memory for its association with something else in the diet?

Js290 - yup, it is nuts to consume diet soda. There is nothing redeeming about the stuff, consuming it is correlated with kidney disease, htn, weight gain - and it tastes terrible. I suppose I should stop drinking it! In truth I restarted drinking them during times of extreme sleep deprivation due to the kids last winter. When kids started sleeping better reduced considerably and no more now, obviously. I feel very ill after drinking regular soft drinks and have for years or I probably would have switched to them.

Well, I too am human with weaknesses. Now you know. My persona is shattered.

However, I think publically admitting my flaw is helping me not drink them, and my mindset now is less, "oh, it's only one" and back to the much more sensible "you don't even like the taste and they have no redeeming qualities whatsoever and there is good reason to believe they are for many reasons poisonous so don't ever drink them again."

So thanks, blog readers, for holding me publically accountable as part of the Whole30 intervention!

What do you think about butter, be it raw or pasteurized pastured butter? Conservative paleo-advocates like Cordain don't recommend it because it wasn't available to us until the last thousands of years but it seems many paleo-bloggers like Kurt Harris, Mark Sisson, etc. include it as a healthy fat despite the fact it is dairy.

I think you'll be surprised at the improvements you'll feel. I thought I was feeling really good having been Primal (with some dairy) for 18 months, then I decided that all evidence was to cut out dairy. I did this 2 months ago (still use a little butter to sautee) and it has made another improvement to my sense of well being and a big difference to my leanness. This I consider a result!

The diet coke thing ... the combination of caffeine and the sweet taste regardless of the 'no calorie no glucose reward for the brain' seems to trigger cravings in many people. You are not alone although personally I don't know how anyone can drink the stuff - I think that stems back to doing a science experiment in school 30 years ago where we left one of my 'baby teeth' in a glass for coke for a few days ... the result is enough to put you off the stuff for life - the brain is a wonderful thing eh!

You have little people, if they've lost a tooth (or you've kept any of yours) give it a try!

Primordial - I use pasture butter frequently - due to a small amount of casein, other milk proteins in it I am abstaining for the Whole30 - though as I mentioned in the post, once every couple of days (probably) I will be consuming pastured ghee (which is clarified butter, the proteins removed). That is not Whole30 approved and my only deviation - mostly because my kids need the vitamin K2 and it is awkward to cook a meal (except eggs - as I like them poached anyway and the kids only eat scrambled) with separate fats.

Cavegirl - Despite many years of drinking the stuff daily (prior to pregnancies - during which I abstained, and thereafter never drank nearly as much as I did before) - I still have no cavities. But I agree it is appalling. I don't smoke but I believe soda and diet soda are the nutritional equivalent. I wish they weren't so inexpensive and ubiquitous.

There are other details to the Whole30 Success Guide as to when and how to eat, how to prepare foods and how much to eat of what, and an excellent recipe guide at the end. I'm not going to share all the details of the program as that wouldn't be too nice to Dallas and Melissa!

I can say (now, in the midst of Day 3) - I am hungry three times a day, which is unusual for me, typically I would eat 1-2 times a day, I have had two very good nights of sleep. I haven't weighed myself but I feel and look a bit leaner. I miss chocolate the most - however, I've had some coconut cocoa tea with a splash of coconut milk. Given that how I am eating isn't too terribly different from how I was eating (except the chocolate and twice weekly cheese, and 2 glasses of wine 3 days a week, and the occasional diet coke, I will have to rethink adding some of those back in. I'm happy with giving up diet coke forever, I won't give up chocolate, but I might ratchet back the wine to two days a week and put the cheese into my "rare" category along with mexican food and BBQ ribs. I might switch my pizza consumption from once a month to once every couple of months - we use a gluten-free crust sometimes and just regular pizza other times, but my husband typically makes it from scratch, more or less.

Anyway, those are the things I'm considering at this point. Only three days in! 90% of the Whole30 left to go.

Emily, thanks for answering. Though, My question regarded the general consumption and if you know if there is scientific evidence against pastured butter. For example, there are pharmacological active opioids in milk protein (casomorphins, lactorphins, etc) so is it likely to find them in butter, too? If milk protein is somehow connected to schizophrenia, autism, skin problems, irritable bowel syndrome, headaches, etc. then why is butter ok?

Butter fat (ghee) is different (better!) off course, since the casein and other proteins are reduced to almost nothing. But who can afford raw, pasture ghee? Not me. Even eating organic without neolithic food groups makes food the highest expense for me. So if I find more evidence against butter I may cut it out and use ghee occasional as a pricy exception.

I think the whole30 approach is an interesting try and I am interested in your results because I am experimenting with different paleo diets.

I included butter a week ago along with some fruits and now I wonder about the culprit for my returning acne, the butter or the high glycemic fruits.

Im a firm believer that the dose makes the poison. Pasture butter has a lot of good things in it and a small amount of milk protein. I also don't consume a ton of butter - the whole family probably goes through less than a stick a week, mostly with the morning eggs or with steak or veggies.

I just buy pasture ghee at the store. A big jar was $8 and I've had the same jar for 6 months. It will go more quickly than usual this month...

There are exceptions to the "dose makes the poison" rule - in autoimmune disease, allergy a very small amount can be very bad… I can't believe how expensive the pasture ghee is there! Wow. I wouldn't buy that either. And in my mind, the whole point of butter is to get the K2 and butryate, so you're only halfway there with conventional butter.

In my experience, cheats have not done me wrong except gluten causes a spot of acne the next day, almost every time I consume it. Infammation in a nutshell! I'm not a big bread fan, and to be honest, if my husband didn't make the pizza and it didn't smell so good, I wouldn't eat any gluten that I could avoid.

Another good night's sleep starting Day 4 of the Whole30, by the way. Which is interesting, because when I started paleo last year (and was very strict for 3 months), there was a time when I didn't sleep well and didn't feel like I needed much sleep - it was also when I was losing fat at a rapid clip, and I've heard that from others doing the same… I don't think I was manic ;-)

Re: Easy Stretch/Flex Technique - Arthur De Vany Membersby Arthur De VanyAsymmetry and over use syndrome. Crossfit is murder for the shoulders. About now, I feel badly over having once recommended it. It has evolved into a poor method and become competitive. The variety, the intensity, the more or less natural moves it once espoused don't seem to be there any more. The Crossfit workout Robb and the Brooklyn gym owner did for our Nightline episode struck me as strange and not challenging but for the pushes to overhead that Robb did. There go the shoulders. The eccentric stress of catching the weight as it falls to the shoulders is murder.

isn't the Diet Coke just a leftover from the previous sugar addiction? I used to drink regular Coke quite a lot, even longer after I eliminated all other candies and sweet drinks. I guess my mind (or my body)just could not get over the thought that I would stop sugar completely.

Then I realized that chocolate is another source of sugar I adore, present even in those "approved" brands. Only then I was able to let the Coke addition go. So technically I am still there, addicted to sugar, or the taste of sweetness.

Gobbledy - Crossfit has worked well for me and while I've been sore, I'm becoming stronger and leaner with each workout. I've not been pushed to do anything that would result in injury - I'm not particularly physically gifted, so I doubt I will ever be competitive.

Tomas - it is possible. I have some chocolate tea that works well right now.

I love the blog... but one suggestion would be to have all of your links open to a new window. I like to read where you've gotten info, and it always takes me away from your page. Just a good habit from a traffic POV.

I take "thyroid synergy" from a pharmaceutical grade company, designs for health. It has iodine, selenium, chromium, a bit of copper - most of PHD's most important ones. also magnesium at night. Mostly to make up for all the times I forget to add in beef liver. Sometimes if I haven't had fish all week I take some omega3. In the winter I have a D/k2 combo but I dont take that daily. Always glad to have doctors stopping by the blog.

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About Me

Emily Deans, M.D.: I'm a psychiatrist in Massachusetts searching for evolutionary solutions to the general and mental health problems of the 21st century. Disclaimer: This information is for educational purposes only, and is in no way intended to be personal medical advice. Please ask your physician about any health guidelines seen in this blog, as everyone is different in his or her medical needs.